Chapter 42
Urinary and Reproductive System Disorders
LEARNING OUTCOMES:
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Define the key terms and key abbreviations listed in this chapter
Describe urinary tract infections and the care required
Describe prostate enlargement and the care required
Describe urinary diversions and the care required
Describe renal calculi and the care required
Explain the difference between acute renal failure and chronic renal failure and
the care required
Describe sexually transmitted diseases and the care required
URINARY
SYSTEM DISORDERS
infections (UTIs)
•Infection in one area can involve the entire system.
•Microbes can enter the system through the urethra.
•Common causes include:
Catheterization
Urological exams
Intercourse
Poor perineal hygiene
Immobility
Poor fluid intake
•UTI is a common healthcare-associated infection.
Urinary tract
•Women are at high risk.
Microbes can easily enter the short female urethra.
•Prostate gland secretions help protect men from UTIs.
An enlarged prostate increases the risk of UTI in older men.
•The following increase the risk of UTIs in older men and women:
Incomplete bladder emptying
Perineal soiling from fecal incontinence
Poor fluid intake
Poor nutrition
Cystitis
is a bladder infection caused by bacteria.
•The following signs and symptoms are common:
Urinary frequency
Oliguria (scant amount of urine)
Urgency
Dysuria (difficult or painful urination)
Pain or burning on urination
Foul-smelling urine
Hematuria (blood in the urine)
Pyuria (pus in the urine)
Fever
•Treatment includes antibiotics and encouraging fluids.
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Pyelonephritis
is inflammation of the kidney pelvis.
•Infection is the most common cause.
•Cloudy urine may contain pus, mucus, and blood.
•Signs and symptoms include:
Chills, fever, back pain
Nausea and vomiting
The signs and symptoms of cystitis
•Treatment involves antibiotics and fluids.
Prostate
enlargement
•The prostate is a gland in men.
It lies in front of the rectum and just below the bladder.
The prostate surrounds the urethra.
•The prostrate enlarges as the man grows older.
This is called benign prostatic hyperplasia or benign prostatic hypertrophy (BPH).
•BPH causes urinary problems.
The enlarged prostate presses against the urethra. This obstructs urine flow through the
urethra.
•These problems are common:
A weak urine stream
Frequent voidings of small amounts of urine
Urgency and leaking or dribbling of urine
Frequent urination at night
Urinary retention
•Treatment depends on the extent of the problem.
The doctor may order drugs to shrink the prostate or stop its growth.
Some microwave and laser treatments destroy the excess prostate tissue.
Transurethral resection of the prostate (TURP) is a common surgical procedure.
Urinary diversions
•Sometimes the urinary bladder is surgically removed.
Cancer and bladder injuries are common reasons.
•A new pathway (urinary diversion) is needed for urine to exit the body.
Often an ostomy is involved.
•A urostomy is a surgically created opening between the ureter and the abdomen.
•A pouch is applied over the stoma.
Urine drains through the stoma into the pouch.
Pouches are changed every 5 to 7 days.
A pouch is replaced anytime it leaks.
Renal
calculi
•Renal calculi are kidney stones.
•Risk factors include:
Being a white male between the ages of 20 and 40 years
Bedrest
Immobility
Poor fluid intake
•Stones vary in size.
•Signs and symptoms include:
Severe, cramping pain in the back and side just below the ribs
Pain in the abdomen, thigh, and urethra
Nausea and vomiting
Fever and chills
Dysuria (difficult or painful urination)
Urinary frequency
Urinary urgency
Burning on urination
Oliguria (scant amount of urine)
Hematuria (blood in the urine)
Cloudy urine
Foul-smelling urine
•Treatment involves:
Drugs for pain relief
Drinking 2000 to 3000 mL of fluid a day
Straining all urine
Surgical removal of the stone if necessary
•Some dietary changes can prevent stones.
Renal
failure (kidney failure)
•In renal failure, the kidneys do not function or are severely impaired.
Waste products are not removed from the blood.
The body retains fluid.
–Heart failure and hypertension easily result.
Acute
renal failure is sudden.
•There is severe decreased blood flow to the kidneys.
•Causes include:
Severe injury or bleeding
Myocardial infarction
Heart failure
Burns
Infection
Severe allergic reactions
•Hospital care is needed.
•Some persons develop chronic renal failure.
•Treatment involves drugs, restricted fluids, and diet therapy.
Chronic
renal failure
•The kidneys cannot meet the body’s needs.
Nephrons in the kidney are destroyed over many years.
•Common causes are:
Hypertension
Diabetes
•Other causes include:
Infections
Urinary tract obstructions
Tumors
•Signs and symptoms appear when 75% of kidney function is lost.
•Treatment involves fluid restriction, diet therapy, drugs, and dialysis.
•Dialysis is the process of removing waste products from the blood.
Hemodialysis removes waste and fluid by filtering the blood through an artificial
kidney.
Peritoneal dialysis uses the lining of the abdominal cavity (peritoneal membrane) to
remove waste and fluid from the blood.
REPRODUCTIVE
DISORDERS
The male reproductive system:
•Produces and transports sperm
•Deposits sperm in the female reproductive tract
•Secretes hormones
The female reproductive system:
•Produces eggs (ova)
•Secretes hormones
•Protects and nourishes the fetus during pregnancy
Aging, many injuries, diseases, and surgeries affect the structures and functions of the
reproductive system.
A
sexually transmitted disease (STD) is spread by oral, vaginal, or anal sex.
•People may not have signs and symptoms.
•Some may not be aware of an infection.
•Some know but do not seek treatment because of embarrassment.
STDs occur:
•In the genital and rectal areas
•In the ears, mouth, nipples, throat, tongue, eyes, and nose
Using condoms helps prevent the spread of STDs.
Some STDs are also spread through skin breaks, by
contact with infected body fluids,
and by contaminated blood or needles.
•Standard Precautions and the Bloodborne Pathogen Standard are followed.